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Comparative Study
. 2020 Oct 19;15(1):59.
doi: 10.1186/s13017-020-00340-1.

The incidence of geriatric trauma is increasing and comparison of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients

Libing Jiang  1 , Zhongjun Zheng  1 , Mao Zhang  2
Affiliations
Comparative Study

The incidence of geriatric trauma is increasing and comparison of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients

Libing Jiang et al. World J Emerg Surg. .

Abstract

Purpose: The study aimed to examine the changing incidence of geriatric trauma and evaluate the predictive ability of different scoring tools for in-hospital mortality in geriatric trauma patients.

Methods: Annual reports released by the National Trauma Database (NTDB) in the USA from 2005 to 2015 and the Trauma Register DGU® in Germany from 1994 to 2012 were analyzed to examine the changing incidence of geriatric trauma. Secondary analysis of a single-center cohort study conducted among 311 severely injured geriatric trauma patients in a level I trauma center in Switzerland was completed. According to the in-hospital survival status, patients were divided into the survival and non-survival group. The differences of the ISS (injury severity score), NISS (new injury severity score), TRISS (Trauma and Injury Severity Score), APACHE II (Acute Physiology and Chronic Health Evaluation II), and SPAS II (simplified acute physiology score II) between two groups were evaluated. Then, the areas under the receiver-operating characteristic curve (AUC-ROC) of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients were calculated.

Results: The analysis of the NTDB showed that the increase in the number of geriatric trauma ranged from 18 to 30% between 2005 and 2015. The analysis of the DGU® showed that the mean age of trauma patients rose from 39.11 in 1993 to 51.10 in 2013, and the proportion of patients aged ≥ 60 years rose from 16.5 to 37.5%. The findings from the secondary analysis showed that 164 (52.73%) patients died in the hospital. The ISS, NISS, APACHE II, and SAPS II in the death group were significantly higher than those in the survival group, and the TRISS in the death group was significantly lower than those in the survival group. The AUCs of the ISS, NISS, TRISS, APACHE II, and SAPS II for the prediction of in-hospital mortality in geriatric trauma patients were 0.807, 0.850, 0.828, 0.715, and 0.725, respectively.

Conclusion: The total number of geriatric trauma is increasing as the population ages. The accuracy of ISS, NISS and TRISS was higher than the APACHE II and SAPS II for the prediction of in-hospital mortality in geriatric trauma patients.

Keywords: Aging population; Elderly trauma; Geriatric trauma; In-hospital mortality; Scoring tool.

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Conflict of interest statement

We declare no competing interests.

Figures

Fig. 1
Fig. 1
a The change trend of trauma patients aged < 65 vs ≥ 65 using the data of NTDB. b The mortality change trend of trauma patients aged < 65 vs ≥ 65 using the data of NTDB. c, d The age change trend of trauma patients using data of DGU. e The age change trend of Chinese people.
Fig. 2
Fig. 2
The comparison of ISS, NISS, APACHE II, SPAS II, and TRISS between the survival group and death group. ISS, injury severity score; NISS, new injury severity score; SPAS II, simplified acute physiology score II; APACHE II, Acute Physiology and Chronic Health Evaluation II; TRISS, Trauma and Injury Severity Score
Fig. 3
Fig. 3
The AUC of ISS, NISS, APACHE II, SPAS II, and TRISS in predicting in-hospital mortality among geriatric trauma patients. ISS, injury severity score; NISS, new injury severity score; SPAS II, simplified acute physiology score II; APACHE II, Acute Physiology and Chronic Health Evaluation II; TRISS, Trauma and Injury Severity Score
See this image and copyright information in PMC

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